Rabies vaccine was first invented as early as around 1885 by Louis Pasteur. I was just wondering why rabies virus has very insignificant medical advancement and is still 100% lethal with no cure.
In: Biology
Reality the human body already has the antibodies to fight rabies. The issue is rabies is extremely effective in hiding from the immune system. All the vaccine is just inactive rabies virii cells so the body finds it and sends the immune system into search and destroy mode for the live virii.
No viral illnesses ever been cured. That isn’t how it works. If the virus gets in you and is able to bring it successfully then it is in your own cells and it is using your own cells to expand.
Your only option with any viral disease is to manage the symptoms and let the immune system do its job, possibly with the help of a vaccine helping it to select for effective antibody production.
The biggest reason rabies is such a problematic virus is because it is able to get past the blood-brain barrier. And it then infects the brain. And even most of our own immune system cannot get past the blood-brain barrier. For the most part the brain has to rely on its own immune system and the fact that it is just so hard to get to.
Having worked it the vaccine/drug development field for many years, I would sadly say to the OP that the true reason is that rabies is a rare infection, and it’s not particularly contagious in humans, so there’s no profit in developing a treatment. Vaccines are generally easier to develop, and you have an unending market for them, so a vaccine is considered good enough.
It’s only 100% lethal if it gets into your brain before you realize you have it.
At virtually any point from exposure (when you’re bitten by the infected animal typically) up until you start displaying neurologic symptoms, it can be treated with [post-exposure prophylaxis](https://www.cdc.gov/rabies/hcp/prevention-recommendations/post-exposure-prophylaxis.html), which is usually highly successful at stopping the infection, although the sooner you seek treatment, the more likely it is to be successful.
Even once it gets into the brain it’s not *absolutely* 100% lethal, as there have been just a few cases where people survive it. I’ve seen sources cite anywhere from 20-30 documented survivors of full-blown rabies *ever* (and most of those had been previously vaccinated). I mean, that’s a vanishingly small minority, given rabies kills as much as 60,000 people annually, most of them in India and Africa, but it’s not zero.
The closest we come to a cure is a fairly effective vaccine and post-exposure treatment.
Why is it so hard to treat once it’s in the brain though? Because it’s hard to treat ANYTHING in the brain. The brain is extremely sensitive, and as a matter of survival, the body is designed to keep most of the immune system from being active in there (because the immune system’s tactics can be pretty destructive, and the brain is less resilient than most other systems). In addition, the blood-brain barrier keeps most medications out of the brain.
Most of our treatments for viral illness are things like vaccines to give the immune system a heads up that the disease is coming, or anti-viral drugs that inhibit replication of the virus until the immune system can get up to speed and fully suppress it. We don’t really have those options inside the brain itself.
You can read up on the Milwaukee Protocol, though. It’s basically putting the patient in a medically induced coma and providing supportive care to minimize damage until the disease runs its course.
It doesn’t have a blanket 100 lethality. It’s 100% lethal once it’s developed past the incurable point, which is when it causes encephalitis. Basically there just isn’t enough time at that point. Your brain is a really delicate organ so once a virus attacks it, it’s damaged beyond repair very quickly. At that point it doesn’t really matter if you cure the virus. You’re a vegetable.
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Basically, rabies destroy things that won’t heal. There is no cure that grows internal tissues back, especially not brain tissue. If you don’t prevent it from happening, it’s already too late. It’s not a matter of “still” ; as far as science went to this day, it’s impossible. We’d have to make a huge leap in stem cells to ever have a chance to cure rabies, IF that’s possible itself. When the mere concept behind the theorical possible source of a theorical cure is itself a theory, you can go with “impossible” for decades.
Strictly speaking, there is a cure: the Milwaukee Protocol. It’s just very rarely effective.
https://www.esanum.com/today/posts/the-milwaukee-protocol-is-applied-on-a-human-rabies-case-in-the-usa
People HAVE been saved with it. But it’s phenomenally expensive, very hard on the body even if you live, and is really more of a last-ditch Hail Mary than a reliable fix.
The rabies vaccine is also the cure for rabies. This treatment can be given before or after exposure and if given promptly (within 10 days of exposure), it is 100% effective. If an individual is already vaccinated, such as those that work regularly with wildlife, then only a booster is needed after exposure.
Rabies is a sneaky virus. It infects the nervous system in an asymptomatic way which allows it to hide from the body’s immune system. It slowly makes its way to the brain, crosses the blood-brain barrier, and promptly treats the delicious brain matter as a buffet.
The human body is capable of fighting off the rabies virus after symtpoms present but the aggressive nature of the virus means that death almost always occurs before the body can build up its own immune response. Rapid medical intervention intended to protect the brain from the virus can allow the body to fight off the virus naturally but success is very low (around 15%) and severe neurological damage is almost inevitable.
The reason why there isn’t a post-symptomatic rapid treatment for rabies is because the pesky blood-brain barrier
The Rabies Vaccine can actually be used as a sort of cure if administered soon enough in humans, due to the slow growing nature of the infection. The vaccine can help you build a resistance to it faster than the infection can take hold.
[https://www.mayoclinic.org/diseases-conditions/rabies/diagnosis-treatment/drc-20351826](https://www.mayoclinic.org/diseases-conditions/rabies/diagnosis-treatment/drc-20351826)
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